Floor J. Backes, MD, associate professor, Division of Gynecologic Oncology, at The Ohio State University Comprehensive Cancer Center, discusses the utility of sentinel lymph node mapping in patients with cervical cancer.

Sentinel lymph node mapping can be an accurate way of assessing potential lymph node involvement in patients with cervical cancer. It has a high sensitivity and detection rate with a low negative predictive value, says Backes. There is, however, a learning curve associated with the procedure, and practice is required to ensure that the sentinel nodes are not overlooked during the operation, she adds.

Nonetheless, it is a great option for patients, as it can reduce the morbidity associated with lymphadenectomy. Now that its use is becoming more widespread in practice, physicians have to take a step back and consider how to optimize the approach, explains Backes. For example, it can be done as an open procedure or robotically, and physicians must ensure that their techniques are the best they can be. Given that data do support the safety and efficacy of the procedure, it is here to stay, Backes concludes.

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Dr. Backes on the Utility of Sentinel Lymph Node Mapping in Cervical Cancer

Floor J. Backes, MD, associate professor, Division of Gynecologic Oncology, at The Ohio State University Comprehensive Cancer Center, discusses the use of sentinel lymph node mapping in patients with cervical cancer.

The goal of sentinel lymph node mapping is to limit the morbidity associated with lymphadenectomy, while still being able to identify any potential lymph node involvement, explains Backes. Then, an appropriate treatment plan can be prescribed, she adds.

Typically, the procedure consists of a blue dye—either methylene blue, isosulfan blue, or patent blue. Oftentimes, a different method with lymphoscintigraphy is used, in which technetium-99 is injected directly into the cervix, says Backes. Either lymphoscintigraphy or a handheld probe can be used, she adds. Depending on whether the procedure is done as an open surgery or as a minimally invasive surgery, an immunofluorescent dye can be used, such as indocyanine green, which can then be detected with a near infrared light or camera, says Backes.

Dr. Backes on Sentinel Lymph Node Mapping in Cervical Cancer

Floor J. Backes, MD, associate professor at The Ohio State University Comprehensive Cancer Center, discusses combinations with PARP inhibitors in the treatment of patients with ovarian cancer.

The PARP inhibitors rucaparib (Rubraca), olaparib (Lynparza), and niraparib (Zejula), are all currently approved in the treatment landscape of ovarian cancer. Currently, there are trials of PARP inhibitors in combination with other agents, including immunotherapy, says Backes. For example, there is a trial opening at The Ohio State University Comprehensive Cancer Center investigating the combination of mirvetuximab soravtansine and rucaparib.

Backes says that the rationale for combining PARP inhibitors with other agents is to increase the change of response. If different mechanisms work toward treating the cancer, developing resistance may be avoided.

Floor J. Backes, MD, associate professor at The Ohio State University Comprehensive Cancer Center, discusses combinations with PARP inhibitors in the treatment of patients with ovarian cancer.
 

Floor J. Backes, MD

Articles

Dr. Backes on the Utility of Sentinel Lymph Node Mapping in Cervical Cancer

Dr. Backes on Sentinel Lymph Node Mapping in Cervical Cancer

Dr. Backes Discusses PARP Inhibitor Combinations in Ovarian Cancer